![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 51 to 75 of 93. Go back in thread:
Posted by Dr. Bob on April 8, 2003, at 22:29:45
In reply to Larry, Ron, jrbecker, posted by McPac on April 8, 2003, at 16:24:42
> Herbert Benson's book "The Relaxation Response" is about this very process.
I'd just like to plug the double double quotes feature at this site:
http://www.dr-bob.org/babble/faq.html#amazon
The first time anyone refers to a book without using this option, I post this to try to make sure he or she at least knows about it. It's just an option, though, and doesn't *have* to be used. If people *choose* not to use it, I'd be interested why not, but I'd like that redirected to Psycho-Babble Administration:
http://www.dr-bob.org/babble/admin/20020918/msgs/7717.html
Thanks!
Bob
Posted by Questionmark on April 9, 2003, at 0:37:12
In reply to Re: Cortisol » Dave1, posted by Pfinstegg on April 8, 2003, at 21:04:00
... and meds:
Honestly now-- this really concerns me-- i understand that depression and anxiety and the associated high cortisol levels can damage the brain (esp. the hippocampus [?]), but do you think that any medications can as well (even those to COMBAT depression/ anxiety)? i mean excitotoxicity is a major means by which brain cells die (esp in the hippo.) right? So if certain drugs elevate neurotransmitter levels too high then can this be damaging? (Particularly maybe with a glutamatergic drug like modafinil cuz glutamate excitoxicity in the hippocampus seems to be a common means of neuronal death[?]) --Or heck with any psychoactive med though.? And like with alcohol i think the main way it kills brain cells is because at first it enhances GABA transmission and thereby decreases glutamate release, and then there is a rebound excess release of glutamate as the alcohol is eliminated. So could benzodiazepines possibly cause brain damage as well?
i have read articles discussing whether SSRIs can kill serotonergic neurons and whether amphetamines (or at least meth) can kill dopaminergic neurons. This may not have been proven but it hasn't been disproven either has it? i am concerned. And i CERtainly believe that antidepressant (or what have you) withdrawal can damage the brain and probably really elevate cortisol/stress levels. Ever since coming off Paxil a few months ago i've felt that my mind just hasn't been working right-- like seriously, i can't come up with words, my memory is just horRENdous, and, ah i dunno, i just can't think. (i am currently not on any meds.) Many docs would probably just attribute this to the depression and relapse (er relapse- worsening) from Paxil. But i think that very often what they call RELAPSE is much more a factor of WITHDRAWAL (or just plain due to withdrawal). Relapse my ass.
i'm sorry this is so dam* long. But please provide some of your thoughts on this stuff.
Posted by Pfinstegg on April 9, 2003, at 8:48:47
In reply to Important questions regarding hippocampal damage.., posted by Questionmark on April 9, 2003, at 0:37:12
You have raised an extremely important question about the effects of various AD's themselves on the hippocampal neurons. I don't know as much about this as you do, as I haven't yet come across any articles about it; all the same, it is a concern which I share. The degree of both side effects and withdrawal symptoms from some ADs, particularly in the SSRI group, but also including the SNRIs, make me very uneasy as to whether they are causing harm in the long run.
Not having a more definite answer, I tend to rely on the reports of people here on PB who rely on fish oil, exercise, meditation, etc. plus SMALL doses of ADs and sometimes benzos- often their dosages are considerably beow what would be considered therapeutic, but this seems to be a group in which treatment satisfaction is quite high. Have you noticed this also?
Pfinstegg
Posted by Ron Hill on April 9, 2003, at 9:45:03
In reply to Re:Closer to profound than slight. (nm) » Ron Hill, posted by Larry Hoover on April 8, 2003, at 12:36:16
Larry,
Did you take another 50mg dose of DHEA yesterday? How about today? Has the improved mental clarity subsided? What is your opinion of the usefulness of DHEA supplementation based on your early results of this most recent trial?
-- Ron
Posted by Larry Hoover on April 9, 2003, at 12:19:11
In reply to Re: DHEA Trial » Larry Hoover, posted by Ron Hill on April 9, 2003, at 9:45:03
> Larry,
>
> Did you take another 50mg dose of DHEA yesterday? How about today? Has the improved mental clarity subsided? What is your opinion of the usefulness of DHEA supplementation based on your early results of this most recent trial?
>
> -- RonI took 50 mg DHEA on arising, yesterday. I had a substantial increase in mental activity/acuity, and moderate insomnia once again. Frankly, I get a similar reaction to betaine. I didn't take DHEA today. I did take some NADH (sublingual this time), and the combination seems to be quite effective. I feel exceedingly sharp, and calm.
Lar
Posted by Larry Hoover on April 9, 2003, at 12:27:24
In reply to Important questions regarding hippocampal damage.., posted by Questionmark on April 9, 2003, at 0:37:12
It's only in the last decade that we've come to realize just how resilient the brain is. New cells are formed, and new connections between existing cells are created, every day of our life. Yes, there is some evidence for hippocampal injury during depression, but SSRIs have been shown to reverse that process. When SSRIs stop working, it may well be because the pathology of depression has found another way to injure the brain. SSRIs and all other antidepressants have been shown (via what is called functional neuroimaging) to "correct" some aspects of brain physiology, but not all of them. In a sense, then, antidepressants are an incomplete treatment. Disappointments over treatment outcomes or issues of antidepressant-derived brain injury may well be well be depression doing its dirty work despite treatment. That's why I focus on other aspects of self-care: feeding my brain what it needs, listening to my body *intently*, exercise, rest, cognitive/behavioural interactions, and so on. Depending solely on medication is a foolish decision, IMHO.
Lar
Posted by jemma on April 9, 2003, at 13:10:14
In reply to Re: Important questions regarding hippocampal damage.. » Questionmark, posted by Pfinstegg on April 9, 2003, at 8:48:47
I consider this to be absolutely the most critical question to ask regarding our use of meds. Namely, are they neuroprotective or neurodamaging? I took zoloft for nine years. The first year was great, and the second year it continued to have some mood-elevating effect. But then followed seven years of weight gain, increasing memory loss, numbness, apathy and lethargy, and chronic hormonal imbalance that resulted in various health problems. Yet I blame myself - had I read the printed material that comes with the pills, I could have seen for myself that "in animals, chronic use has been shown to result in downloading of catecholamine receptors." So I was suffering, as I'm sure many of us are, from a chronic and ever-worsening shortage of norepinephrine and dopamine.
Finally, my pdoc switched me to catecholamine- enhancing drugs, and after much trial and error, came up with the combination of modafinil and ritalin. I was awake for the first time in a decade! But I became increasingly wary of evidence that ritalin ultimately depletes, and even kills, dopamine cells. MOdafinil worried me less, as it's been shown to be neuroprotective. I know glutamate causes excitotoxicity, but gaba in excess is also toxic. My brain seems to need glutamate to feel awake. Anyway, I substituted selegiline for ritalin, and it worked even better for focus and concentration. And selegiline protects dopamine neurons, instead of killing them.
From now on, I am only interested in meds and supplements that protect my brain and promote its balance. Fortunately, such meds and supplements do exist, and I'm grateful to Larry, Pfinstegg, Scott, and so many others on this board who have helped me to find them.
- jemma
Posted by Ron Hill on April 9, 2003, at 13:57:11
In reply to Re: DHEA Trial, posted by Larry Hoover on April 9, 2003, at 12:19:11
Hey Larry,
> I took 50 mg DHEA on arising, yesterday. I had a substantial increase in mental activity/acuity, and moderate insomnia once again. Frankly, I get a similar reaction to betaine. I didn't take DHEA today. I did take some NADH (sublingual this time), and the combination seems to be quite effective. I feel exceedingly sharp, and calm.
Thank you very much for the update. To avoid being a pest, I promise to limit the number of my questions and minimize the number of my posts to you soliciting information. At the same time, however, I'm very interested in the results of your DHEA/Enada NADH trial and I'd love to have a short "daily briefing" regarding your anecdotal experience over the next few weeks. Further, your brief daily documentation would be a worthwhile contribution to the PB archives.
My current cocktail (600 mg/day of Lithobid and 2.5 mg per every four days of Enada NADH) is currently working so well that I do not want to run the risks involved in trying to fix something that is not broken. Having said that, I am itching to try a low-dose (5 mg/day) DHEA add-on. As an aside, I would like to get a cortisol test prior to beginning my DHEA trial (if any) to provide baseline cortisol level data.
Larry, do you think that your "moderate insomnia" could be resolved for you by reducing your DHEA dosage?
Also, do you think that johnj might benefit from a low-dose of DHEA taken in the mornings? On the downside, it might interfere with his sleep (at least initially) and/or it might cause some anxiety/irritability for John. On the upside, it might give him the energy and mental clarity that he wants and needs.
-- Ron
Posted by Larry Hoover on April 9, 2003, at 16:28:27
In reply to Re: DHEA Trial » Larry Hoover, posted by Ron Hill on April 9, 2003, at 13:57:11
> Hey Larry,
>
> > I took 50 mg DHEA on arising, yesterday. I had a substantial increase in mental activity/acuity, and moderate insomnia once again. Frankly, I get a similar reaction to betaine. I didn't take DHEA today. I did take some NADH (sublingual this time), and the combination seems to be quite effective. I feel exceedingly sharp, and calm.
>
> Thank you very much for the update. To avoid being a pest, I promise to limit the number of my questions and minimize the number of my posts to you soliciting information. At the same time, however, I'm very interested in the results of your DHEA/Enada NADH trial and I'd love to have a short "daily briefing" regarding your anecdotal experience over the next few weeks. Further, your brief daily documentation would be a worthwhile contribution to the PB archives.I'll try to anticipate your questions by being more explicit up-front. I wouldn't want you to have to keep asking questions. <wink>
> My current cocktail (600 mg/day of Lithobid and 2.5 mg per every four days of Enada NADH) is currently working so well that I do not want to run the risks involved in trying to fix something that is not broken. Having said that, I am itching to try a low-dose (5 mg/day) DHEA add-on. As an aside, I would like to get a cortisol test prior to beginning my DHEA trial (if any) to provide baseline cortisol level data.
That is wise. Baselines are seldom taken. 5 mg of DHEA is really quite a small dose. My 50 mg dosing is probably higher than I need. I'm sure as hell not going to take it every day. Maybe one day in four?
> Larry, do you think that your "moderate insomnia" could be resolved for you by reducing your DHEA dosage?
Yes. Just a little too much "brain hum" late in the day. I sleep well, just don't initiate smoothly.
> Also, do you think that johnj might benefit from a low-dose of DHEA taken in the mornings?It's certainly something to consider. It's appropriate, based on symptoms. I'm concerned about trying too many supplements too close together. There's lots of time, to get a clear picture.
>On the downside, it might interfere with his sleep (at least initially) and/or it might cause some anxiety/irritability for John. On the upside, it might give him the energy and mental clarity that he wants and needs.
The only thing to do is to try it. That will answer the questions nicely.
> -- Ron
>Lar
Posted by Larry Hoover on April 10, 2003, at 9:02:03
In reply to Re: DHEA Trial » Ron Hill, posted by Larry Hoover on April 9, 2003, at 16:28:27
I have come down suddenly with a nasty virus, and I feel like hell. How I feel is obviously tainted by uncontrolled variables. Today's report is cancelled.
Lar
Posted by Ron Hill on April 10, 2003, at 10:01:54
In reply to Re: DHEA TrialRon Hill, posted by Larry Hoover on April 10, 2003, at 9:02:03
> I have come down suddenly with a nasty virus, and I feel like hell. How I feel is obviously tainted by uncontrolled variables. Today's report is cancelled.
Hi Larry,
So sorry that you feel poorly. Thanks for posting. Get well ASAP!
I called the take-out food place around the corner from where you live and they are going to deliver some chicken soup. Careful not to burn your tongue; It might be hot to the touch.
-- Ron
Posted by johnj on April 11, 2003, at 9:03:44
In reply to Re: DHEA TrialRon Hill, posted by Larry Hoover on April 10, 2003, at 9:02:03
Hi Larry,
How is that nasty virus? It sounds strange, but sometimes I don't mind getting a cold since I seem to focus my attention from my moods to my body and zone out of everything and sleep.
I have had some interesting thoughts this past week and would like to run them by you. Reading some other posts made a light go off, one that I thought had no bearing on my situation. Actually, I didn't want to think it had any bearing, but a few things make sense now. I hope you are feeling better and getting some chicken soup. take care
johnj
Posted by johnj on April 11, 2003, at 9:47:00
In reply to Re: DHEA Trial » Larry Hoover, posted by Ron Hill on April 9, 2003, at 13:57:11
Hi Ron:
Thank you for asking those questions for me, you knew what I was thinking before I could even spit it out. This week hasn't been great for energy or clarity. I haven't had such low energy, even upon waking for a long time. I went down to 100 mg of Mg and may try 200 tonight. I wonder if the relaxing effect somehow interacted with my benzo or something. I am med sensitive so maybe I am supplement sensitive too. Time will tell, but I have been laying down a lot, especially after work. Right now I am just trying to keep my job. take care and thanks for all the help. I just wish I could help people more on here. I hope Colin is doing ok. I hope he has been doing so well he just hasn't had the time to post. take care Ron.
johnj
Posted by colin wallace on April 11, 2003, at 13:54:48
In reply to Re: DHEA Trial » Ron Hill, posted by johnj on April 11, 2003, at 9:47:00
Hey there John Boy,
Sorry I haven't been able to plug in for a few weeks- got mightily pissed off with things and took myself off to a secluded spot in a quest for sunshine(was feeling really ill before I went).In fact, it wasn't quite secluded enough, and I ended up bumping into an old friend and throwing back beer like a fiend.My highly unsound reasoning was that, if I only drank what we call 'shandy'(half lemonade/half beer), then that would of course lead to half the alcohol intake.Trouble is,it's far too refreshing and much easier to drink, so I ended up drinking twice the amount-hence, exactly the same consumption.I'm not destined for a Pulitzer prize for mathematics.
Wondered how you and Ron are doing lately (Ron's Enada trial?);hope I haven't missed any posts adressed to me.
Still doing fairly well at 300mg Lamictal.Re-introduced the Prozac too, as trial and error has shown that I am far less prone to anger with the Prozac aboard(obvious low seratonin/anger correlation here).Prozac, when it works,can actually have a profound and beneficial effect on anger.As I mentioned before, it feels so much smoother in combination with Lamictal.No anxiety, agitation, just an uplift in mood, and far less anger within 2 weeks.
Seems paradoxical, but I now know for certain that, regardless of all else, I'll never be able to function without an additional AD.
My Lamictal is still prone to fading though, and I'll need to hit it soon with another mood stabilizer-have been refused lithium, until I get to see my psych.(three ****** months!!)
I really need something to forestall another inevitable crash once the Lam. wears off, but once again, I'm alone and out on a friggin' limb!
Oh, to live somewhere more civilized and efficient(like Calcutta).
Will be away again for another few weeks, so take care all and seeya soon.Colin, *_-
Posted by Peter S. on April 11, 2003, at 15:21:42
In reply to Re: JohnJ, TCA, posted by colin wallace on April 11, 2003, at 13:54:48
Hi Colin,.
You and I seem to be in similar boats. I'm currently taking Lamictal (50 mg) and Prozac (occasionally). I'm also taking 300mg of Neurontin which seems to curb the irritability related to the Lamictal and may act synergistically. I've been up and down on the Lam (highest dose was 600mg. Honestly sometimes I think a lower dose works better than a higher dose. I still haven't figured out the Prozac piece. It seems to cycle for me, but then sometimes I think it is helpful in small doses.
Last weekend I took a med vacation because the effect had faded out to a large degree. I took 4 days off and restarted the LAM and Neurontin and the effect kicked in much better. One thing about Lam is that I notice effects about an hour after taking- great increase in energy and good improvement in mood. The only problem is that the effect fades in the afternoon. After my med vacation the effect has not been fading as much.
Have you tried taking small vacations? I'm think that I might take 2 days off per week (maybe when I can afford to be in a lousy mood)
Love to hear how things go for you and trade experiences.
Peter
> Hey there John Boy,
>
> Sorry I haven't been able to plug in for a few weeks- got mightily pissed off with things and took myself off to a secluded spot in a quest for sunshine(was feeling really ill before I went).In fact, it wasn't quite secluded enough, and I ended up bumping into an old friend and throwing back beer like a fiend.My highly unsound reasoning was that, if I only drank what we call 'shandy'(half lemonade/half beer), then that would of course lead to half the alcohol intake.Trouble is,it's far too refreshing and much easier to drink, so I ended up drinking twice the amount-hence, exactly the same consumption.I'm not destined for a Pulitzer prize for mathematics.
> Wondered how you and Ron are doing lately (Ron's Enada trial?);hope I haven't missed any posts adressed to me.
> Still doing fairly well at 300mg Lamictal.Re-introduced the Prozac too, as trial and error has shown that I am far less prone to anger with the Prozac aboard(obvious low seratonin/anger correlation here).Prozac, when it works,can actually have a profound and beneficial effect on anger.As I mentioned before, it feels so much smoother in combination with Lamictal.No anxiety, agitation, just an uplift in mood, and far less anger within 2 weeks.
> Seems paradoxical, but I now know for certain that, regardless of all else, I'll never be able to function without an additional AD.
> My Lamictal is still prone to fading though, and I'll need to hit it soon with another mood stabilizer-have been refused lithium, until I get to see my psych.(three ****** months!!)
> I really need something to forestall another inevitable crash once the Lam. wears off, but once again, I'm alone and out on a friggin' limb!
> Oh, to live somewhere more civilized and efficient(like Calcutta).
> Will be away again for another few weeks, so take care all and seeya soon.
>
> Colin, *_-
>
>
Posted by beardedlady on April 11, 2003, at 16:11:18
In reply to Re: JohnJ, TCA, posted by colin wallace on April 11, 2003, at 13:54:48
Posted by Ron Hill on April 12, 2003, at 9:52:53
In reply to Re: JohnJ, TCA, posted by colin wallace on April 11, 2003, at 13:54:48
Hi Colin,
Good to see ya.
> Wondered how you and Ron are doing lately (Ron's Enada trial?);
I'm doing well. Thanks for asking. I take a 2.5 mg tablet of Enada NADH once every four days and it is working well for my atypical depression. As always, I continue to take my 600 mg/day of Lithobid.
> hope I haven't missed any posts adressed to me.
There were a couple. We were wondering what happened to you, but we figured you were gone on holiday.
> My Lamictal is still prone to fading though, and I'll need to hit it soon with another mood stabilizer-have been refused lithium, until I get to see my psych.(three ****** months!!)
Last I heard, you were scheduled to see an expert in bipolar disorder. That didn't happen, huh?
Be well Colin.
-- Ron
Posted by colin wallace on April 13, 2003, at 13:19:21
In reply to Hi, CW! Nice to see your name again! (nm) » colin wallace, posted by beardedlady on April 11, 2003, at 16:11:18
Posted by colin wallace on April 13, 2003, at 13:35:54
In reply to Re: Colin's Cameo Appearance » colin wallace, posted by Ron Hill on April 12, 2003, at 9:52:53
> Hi Colin,
>
> Good to see ya.
>
> > Wondered how you and Ron are doing lately (Ron's Enada trial?);
>
> I'm doing well. Thanks for asking. I take a 2.5 mg tablet of Enada NADH once every four days and it is working well for my atypical depression. As always, I continue to take my 600 mg/day of Lithobid.
>
> > hope I haven't missed any posts adressed to me.
>
> There were a couple. We were wondering what happened to you, but we figured you were gone on holiday.
>
> > My Lamictal is still prone to fading though, and I'll need to hit it soon with another mood stabilizer-have been refused lithium, until I get to see my psych.(three ****** months!!)
>
> Last I heard, you were scheduled to see an expert in bipolar disorder. That didn't happen, huh?
>
> Be well Colin.
>
Hey there Ron,Good to see you're making steady progress still-
2.5mg every four days eh??I'd read that this stuff is best taken at spaced intervals throughout the week ,so obviously there's something in that;I think it's pretty unique in it's lasting effects(I liked it too, but as I said,it was a little too overpowering combined with Lamictal).
I guess you got some irritability taking in on alternate days?Seems you have it nailed down anyhow, so let's hope the effects last consistently.
Oddly, I've found that the dreaded Prozac has been pretty astounding with the Lamictal.It has smoothed out my mood(s),and made me far more sociable(Lamictal got me out of a 2year stupor,and got me socializing again, and Prozac goes the extra mile, and makes me *feel* like socializing).Helps with the SAD too.
It's early days yet, but I'm hoping to add a small dose of lithium shortly, as an extra safeguard.I've realized that there's no way on earth I'll ever get by without an AD, so I've just had to accept it(and any inherant risks).
No signs at all of hypomania, so fingers crossed here.Keep in touch,
Col.
ps.how's Amy??
Posted by colin wallace on April 13, 2003, at 13:57:39
In reply to Colin- your lamictal, posted by Peter S. on April 11, 2003, at 15:21:42
> Hi Colin,.
>
> You and I seem to be in similar boats. I'm currently taking Lamictal (50 mg) and Prozac (occasionally). I'm also taking 300mg of Neurontin which seems to curb the irritability related to the Lamictal and may act synergistically. I've been up and down on the Lam (highest dose was 600mg. Honestly sometimes I think a lower dose works better than a higher dose. I still haven't figured out the Prozac piece. It seems to cycle for me, but then sometimes I think it is helpful in small doses.
>
> Last weekend I took a med vacation because the effect had faded out to a large degree. I took 4 days off and restarted the LAM and Neurontin and the effect kicked in much better. One thing about Lam is that I notice effects about an hour after taking- great increase in energy and good improvement in mood. The only problem is that the effect fades in the afternoon. After my med vacation the effect has not been fading as much.
>
> Have you tried taking small vacations? I'm think that I might take 2 days off per week (maybe when I can afford to be in a lousy mood)
>
> Love to hear how things go for you and trade experiences.
>
> Peter
>
>Hi there Pete,
Yeah, we seem to be tinkering with much the same meds and zigzagging down (up?) the same path!
I liked Neurontin too, but I found that I was experiencing some wierd effects from it- irritability the following day, and some dissociative stuff too, so I binned it.Too risky for me.
Lamictal is a strange ol' med though, I'd agree.Total lifesaver, but so hard to fathom.
I'm back at 250mg now, and the effects are more consistent with Prozac, which I can now tolerate at 20mg on alternate days, with zero side-effects!!That much is true of Lamictal at least.
I think that Lamictal basically needs to be augmented, full-stop.It is prone to fading, but it seems to perform much better with a little outside help.
Gonna try adding lithium soon, as they seem to complement one another-for some.Next in line would be a small dose of Valproate, or maybe Trileptal, whilst keeping the Prozac in the mix.
I'm prepared to mess around with a few AD's if necessary, as they're much easier to tolerate with Lamictal.Will keep you posted.Keep well, and keep us informed.
Col.
ps...med vacations don't work for me at all, unfortunately.
Posted by colin wallace on April 13, 2003, at 14:00:35
In reply to Re: Colin- your lamictal » Peter S., posted by colin wallace on April 13, 2003, at 13:57:39
Posted by Larry Hoover on April 15, 2003, at 18:12:30
In reply to Re: DHEA Trial » Larry Hoover, posted by Ron Hill on April 10, 2003, at 10:01:54
> > I have come down suddenly with a nasty virus, and I feel like hell. How I feel is obviously tainted by uncontrolled variables. Today's report is cancelled.
>
> Hi Larry,
>
> So sorry that you feel poorly. Thanks for posting. Get well ASAP!Your good wishes were insufficient. I just got home from the hospital. I have pneumonia. See ya all later.
Lar
Posted by noa on April 15, 2003, at 20:24:48
In reply to Re: Virus update, posted by Larry Hoover on April 15, 2003, at 18:12:30
Larry, best wishes--be well soon!
Posted by Ron Hill on April 15, 2003, at 20:29:30
In reply to Re: Virus update, posted by Larry Hoover on April 15, 2003, at 18:12:30
> Your good wishes were insufficient. I just got home from the hospital. I have pneumonia. See ya all later.
Shoot. Sorry to hear it Larry. I wish there was something I could do to get you well.That guy at the corner restaurant must have sold me a bum batch of chicken soup. He guaranteed it would work.
-- Ron
Posted by Jonathan on April 15, 2003, at 21:57:33
In reply to Re: Virus update, posted by Larry Hoover on April 15, 2003, at 18:12:30
Go forward in thread:
Psycho-Babble Medication | Extras | FAQ
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.org
Script revised: February 4, 2008
URL: http://www.dr-bob.org/cgi-bin/pb/mget.pl
Copyright 2006-17 Robert Hsiung.
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